Report of a Case with the Villous Adenoma of the Rectum and Sigmoid Colon with Electrolyte Depletion Syndrome and Carcinoma Confining to the Mucosa

Hiroshige Sasaki, Masatomo Hayashi^* and Atsuyoshi Onitsuka^*

Department of General Surgery, Ohta Hospital
First Department of Surgery, Gifu University School of Medicine^*

We report a case of the Villous Adenoma of the rectum and sigmoid colon with electrolyte depletion syndrome and carcinoma confining to the mucosa. A 55-year-old man was admitted with severe diarrhea and vomiting. He had suffered from diarrhea since the age of 40. Physical and laboratory examinations on admission showed a shock state, moderately decreased serum electrolytes (Na 127 mEq/l, K 3.1 mEq/l, Cl 72 mEq/l) and hyperazotemia (BUN 85.1 mg/dl) due to dehydration. Double contrast barium enema examination showed a huge tumor which presented a shaggy appearance in the rectum and sigmoid colon. Endoscopic finding showed the villous tumor in the rectum and slgmoid colon. Histological examination of the biopsy specimen revealed a villous adenoma with adenocarcinoma. He underwent abdominoperineal resection of the rectum with regional lymphadenectomy after fluid and electrolyte adjustment. The tumor was 26×13 cm in size and occupied the circumference of the bowel. Histological findings revealed a villous adenoma with well-differentiated adenocarcinoma confined to the mucosa. His postoperative course was uneventful and he has shown no recurrence for 4 years after the operation.

Key words
villous adenoma of the large bowel, electrolyte depletion syndrome, colorectal carcinoma

Reprint requests
Hiroshige Sasaki Department of General Surgery, Ohta Hospital 2825 Ohta-cho, Minokamo, 505-0041, JAPAN

Accepted
July 28, 1999

To read the PDF file you will need Abobe Reader installed on your computer.